한국 소아에서 모유 수유와 천명 발생 위험의 관계: 2010-2012년 국민건강영양조사자료를 근거로

이경석 ( Kyung Suk Lee ),최선희 ( Sun Hee Choi ),최용성 ( Yong Sung Choi ),오인환 ( In Hwan Oh ),나영호 ( Yeong Ho Rha ) 대한소아알레르기호흡기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.2

Purpose: There is conflicting evidence concerning the relationship between breast-feeding and development of wheezing in early childhood. Epidemiological evidence for a role of breast-feeding on risk of wheezing is inconclusive. The objective of this study was to investigate the associations between breast feeding and risk of current wheezing in early childhood in Korea. Methods: We combined the fifth Korea National Health and Nutrition Examination Survey data collected from 2010 to 2012 and analyzed 1,011 children from 1 to 3 years olds who had been surveyed in regards to breast-feeding. Multivariate regression analysis was used to identify association among the following variables: presence of current wheezing, feeding types and duration of breast-feeding. Results: Prevalence of exclusive breast-feeding and current wheezing decreased both annually from 2010 to 2012. In the univariate analysis, breast-feeding, formula-feeding, duration of breast-feeding were not associated significantly with current wheezing of children younger than 3 years old. No measureable statistically significant relation was observed among breast-feeding, formula-feeding, duration of breast-feeding and risk of current wheezing in the multivariate analysis. Conclusion: The present study showed no statistically significant relationship between breast-feeding and the risk of wheeze in early childhood in Korean children. National prospective study is needed to clarify the role of breast-feeding in development of current wheezing. (Allergy Asthma Respir Dis 2014;2:103-107)

최근 10년간 대구,경북 지역 성인에서 바이러스성 간염 표지자 양성률의 변화양상

이경인 ( Kyung In Lee ),박경식 ( Kyung Sik Park ),서혜진 ( Hye Jin Seo ),김태열 ( Tae Yul Kim ),김은수 ( Eun Soo Kim ),장병국 ( Byoung Kuk Jang ),정우진 ( Woo Jin Chung ),조광범 ( Kwang Bum Cho ),황재석 ( Jae Seok Hwang ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.2

Background/Aims: There have been only few studies on the population-adjusted seroprevalence of HBV and HCV and on the change of them for more than 10 years in Korea. Therefore, this study was performed to evaluate them at a single health center in Daegu and Gyeongbuk province considering the population composition ratio. Methods: We analyzed the seromarkers of HBV and HCV of 6,237 randomly sampled adults who had received health screening at the health promotion center in Dongsan hospital during the periods from year 1997 to 1999 (Period A) and from 2007 to 2009 (Period B). Results: The seroprevalences of HBsAg, anti-HBs, anti-HBc and anti-HCV were 4.8%, 70.2%, 47.4%, and 0.5%, respectively. There is no difference in the seroprevalence of HBsAg between period A and B. However, downward tendency of prevalence through A to B from 6.8% to 4.5% could be found in 40s, and upward tendency from 4.7% to 6.8% in 50s. As for the seroprevalence of anti-HCV, although there was no difference through A to B, for 50s, it decreasd from 2.0% to 0.3% (p=0.007). However, for 60s, it increased as much as decreasd for 50s. Conclusions: The seroprevalence of HBsAg in Daegu/Gyeongbuk province was 4.8% and showed no difference through the time period of 10 years. The seroprevalence of anti-HCV was 0.5% and also showed no difference through the time periods. (Korean J Gastroenterol 2011;58:82-87)

부산지역 교실배식 초등학교생들의 손 씻기 인식 및 이행 실태

이경아 ( Kyung A Lee ),이민영 ( Min Yung Lee ),박인식 ( In Shik Park ) 대한영양사협회 2009 대한영양사협회 학술지 Vol.15 No.3

The principal objective of this study was to evaluate elementary students` awareness of the importance of hand washing, as well as their hand-washing behavior. The data was collected by self-reported questionnaire from 697 students in elementary schools with serving food in a classroom in Busan. Their hand-washing frequency was high, at `3∼4 times per day (37.0%)`. 51.0% of the respondents did not wash their hands that often because they were `not accustomed` to washing their hands, and 35.9% of respondents regarded washing their hands as `annoying`. The most frequently reported hand washing agent was `soap and water (71.4%)`. Approximately 95∼98% of the respondents always washed their hands after using the bathroom, 87.9% of them washed their hands before eating food, and 86.7% of them washed their hands upon returning home. However, 27.3%, 34.1% and 65.9% of the respondents did not wash their hands after handling money, after eating, and after coughing or sneezing, respectively. Significant factors related to increased hand-washing frequency were gender (p<0.001) and the period of attendance at kindergarten (p<0.05). The mean scores of importance and performance of hand washing were significantly higher for girls than for boys. The group with higher rate (over 4.5/5.0) for the importance of sanitary hand-washing behavior showed significantly higher scores in hand-washing behavior before serving food and before eating than those of the lower rated group (below 4.0/5.0). This study shows that sanitation education is required not only for food handlers but also for students in school foodservices.

폐경 전후 여성에서 상완-발목 맥파속도에 영향을 미치는 요인의 비교

정찬경 ( Chan Kyung Chung ),윤보현 ( Bo Hyon Yun ),서석교 ( Seok Kyo Seo ),임경진 ( Kyung Jin Lim ),전영은 ( Young Eun Jeon ),양효인 ( Hyo In Yang ),이경은 ( Kyung Eun Lee ),조시현 ( Si Hyun Cho ),최영식 ( Young Sik Choi ),이병석 대한폐경학회 2010 대한폐경학회지 Vol.16 No.2

연구목적: 본 연구는 45∼56세 사이의 폐경 전후 여성을 대상으로 상완-발목 맥파속도에 영향을 미치는 요인을 비교 분석하고자 하였다. 또한 폐경과 동맥 경직도와의 연관성을 알아보고자 하였다. 연구재료 및 방법: 2008년 1월부터 2009년 6월까지 강남세브란스병원 건강증진센터에 내원하여 건강검진을 받은 여성중 45세 이상이고 56세 미만이면서 상완-발목 맥파속도를 측정한 수검자를 대상으로 하였으며 의무기록을 바탕으로 후향적으로 연구하였다. 폐경 전후 여성에서 상완-발목 맥파속도와 다른 변수들 간의 관련성을 알아보기 위해 단순회귀 분석과 다중회귀분석을 시행하였으며, 폐경이 상완-발목 맥파속도의 증가에 미치는 영향을 알아보기 위하여 로지스틱 회귀분석을 시행하였다. 결 과: 단순회귀분석 및 다중회귀분석에서 폐경 전 여성의 경우 이완기 혈압 (β=0.402, P=0.009)이 통계학적으로 유의한 연관성을 보였으며, 폐경 여성의 경우 이완기 혈압 (β=0.329, P=0.021)과 호중구-림프구 비 (β=0.210, P=0.016)가 통계학적으로 유의한 연관성을 보였다. 이완기 혈압 (OR=1.112; 95% CI 1.034∼1.197), 공복혈당 (OR= 1.034; 95% CI 1.000∼1.069), 폐경 (OR=2.666; 95% CI 1.025∼6.937)이 증가된 상완-발목 맥파속도 (baPWV >1,300 cm/s)와 통계학적으로 유의한 연관성을 보였다. 결론: 폐경 전후 여성에서 상완-발목 맥파속도에 영향을 미치는 요인이 다르며, 특히 폐경 여성의 경우 염증반응이 상완-발목 맥파속도와 뚜렷한 연관성이 있었다. 또한 폐경이 상완-발목 맥파속도를 증가시키는 독립적인 인자였으며, 이는 폐경 이행기의 호르몬 변화가 상완-발목 맥파속도에 영향을 미치는 것으로 생각된다. Objectives: The aim of this study was to compare the factors which influence the brachial-ankle pulse wave velocity (baPWV) in pre- and post-menopausal women. We also investigated the association of menopause with arterial stiffness measured by baPWV. Methods: We performed a retrospective review of 241 postmenopausal women who attended the health promotion center for a routine checkup. Simple and multiple regression analyses were performed to determine the parameters influencing baPWV in pre- and postmenopausal women. Multiple logistic regression analysis was performed to identify the independent parameters related to increased of arterial stiffness. Results: Multiple regression analysis showed that diastolic blood pressure (DBP; β=0.402, P=0.009) was identified as an independent determinant for baPWV in premenopausal women, and DBP (β=0.329, P=0.021) and the neutrophil-to-lymphocyte ratio (NLR; β=0.210, P=0.016) were identified as independent determinants for baPWV in postmenopausal women. The odds ratio (95% CI) of menopause for a high baPWV was 2.666 (1.025∼6.937). Conclusion: The NLR is associated with arterial stiffness in postmenopausal women. Consequently, inflammation is thought to play a crucial role in increased arterial stiffness in postmenopausal women. Menopause is associated with a high baPWV, suggesting that changes in the concentrations of sex hormones during the menopausal transition may influence arterial stiffness in clinically healthy women.

선천성 담도폐쇄증에서 99mTc DISIDA 신티그라피의 진단정확성 ( Diagnostic Accuracy of 99mTc-DISIDA 신티그라피의 진단정확성

현인영,이동수,이경한,김종호,정준기,서정기,이명철,고창순 ( In Young Hyun,Dong Soo Lee,Kyung Han Lee,Jong Ho Kim,June Key Chung,Jung Key Suh,Myung Chul Lee,Chang Soon Koh ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3

We evaluated the diagnostic accuracy of 99mTc-DISIDA scintigraphy as a mean of differentianting biliary tresia from neonatal hepatitis. Tc-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepat,ic retention index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake index was graded visually with 5 minute images using the following scoring scheme :grade 0(normal hepatic uptake), grade 1(decreased hepatic up take), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent int,estinal radioactivity. The results were as follows : l) None of the 30 hiliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity, The sensitivity, specificity, and accuracy of the presence of inlestinal radioactivity .or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patienis with absent intestinal radioactivity the mean hepatic retention index was 1.5+0.6 in the 16 biliary atresia patient,s, and 1.1+0.2 in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary at,resia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake index between biliary atresia and neonatal hepatit.is patients. However t.here were differences in age, total bilirubin, and hepatic uptake index bet.ween neonatal hepatitis patients with and without intestinal radioactivity. The hepatic upt,ake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioact,ivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake index and the hepatic retention index. Thus, we conclude that Tc DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patients age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.

실내 원인 알레르겐인 바퀴벌레의 수도권내 계절별 분포 조사

김우경 ( Woo Kyung Kim ),김철홍 ( Cheol Hong Kim ),이경은 ( Kyung Eun Lee ),손명현 ( Myung Hyun Shon ),장광천 ( Gwnng Cheon Jang ),김규언 ( Kyu Earn Kim ),이인용 ( In Young Lee ),정경용 ( Kyoung Yong Jeong ),이종원 ( Jong Weon 대한천식알레르기학회 2002 천식 및 알레르기 Vol.22 No.4

복막투석 환자에서 항결핵제의 약물역동학

김기원(Ki Won Kim),안규리(Cu Rie Ahn),오국환(Kook Hwan Oh),이경이(Kyung Yi Lee),이중건(Jung Geon Lee),오명돈(Myung Don Oh),김연수(Yon Su Kim),한진석(Jin Suk Han),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),장인진(In Jin Jang),신상구(Sa 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1

N/A Background : Tuberculosis is more prevalent in dialysis patients than in the general population, and more difficult to make a diagnosis, and often leads to death, Moreover, extra-caution is needed in prescribing anti-tuberculosis medications as dose modification is frequently needed in patients with renal insufficiency. Several pharmacokinetic studies have been performed for antimycobacterial regimens in patients with renal insufficiency, including under hemodialysis. However, the anti-mycobacterial regimens of patients on peritoneal dialysis have been made based on empirical methods because of few pharmacokinetic studies. Methods : To elucidate the pharmacokinetic profiles of anti-mycobacterial regimens for peritoneal dialysis, we measured both plasma and peritosol concentrations of anti- tuberculous drugs including isoniazide, rifampin and pyrazinamide in 9 patients maintained on chronic ambulatory peritoneal dialysis(CAPD). Results : After a conventional oral dose of anti-tuberculosis medication, their plasma concentrations were in the therapeutic range, but the peritosol concentration of rifampin was below the therapeutic range. Conclusion : No dose adjustments are required for isoniazid, rifampin and pyrazinamide for the treatment of systemic or peritoneal tuberculosis in CAPD patients. On the contrary, oral rifampin is not expected to be effective in the treatment of tuberculous peritonitis, because of its low peritosol concentration. (Korean J Nephrol 2002; 21(1):67-73)

클로미펜에 얇은 자궁내막을 보이는 환자에서 성선자극호르몬 병합 과배란유도시 클로미펜과 레트로졸의 임상적 효용성

이은주,박현종,양효인,이경은,서석교,김혜연,조시현,최영식,이병석,박기현,조동제,Lee, Eun-Joo,Park, Hyun-Jong,Yang, Hyo-In,Lee, Kyung-Eun,Seo, Seok-Kyo,Kim, Hye-Yeon,Cho, Si-Hyun,Choi, Young-Sik,Lee, Byung-Seok,Park, Ki-Hyun,Cho, Dong-Ja 대한생식의학회 2009 Clinical and Experimental Reproductive Medicine Vol.36 No.2

목 적: 클로미펜을 사용한 배란유도시 얇은 자궁내막을 보였던 환자들에서 성선자극호르몬에 클로미펜 또는 레트로졸을 병합 투여하는 과배란유도 방법의 임상적 효용성을 비교 분석하고자 하였다. 연구방법: 이전의 클로미펜을 사용한 배란유도 주기에서 8 mm 미만의 얇은 자궁내막을 보였던 불임 환자들에서 시행된 성선자극호르몬 병합 과배란유도/인공수정 51주기가 연구에 포함되었다. 월경주기 제3일째부터 5일 동안 클로미펜+성선자극호르몬 군은 일일 클로미펜 100 mg을 투여하였고 (n=26) 레트로졸+성선자극호르몬 군은 일일 레트로졸 2.5 mg 또는 5 mg을 투여하였다 (n=25). 양 군에서 월경주기 제5~7일째부터 우성난포의 크기가 18 mm 이상에 도달할 때까지 이틀에 한 번씩 성선자극호르몬은 75~150 IU를 투여하였다. 양 군에서 성선자극호르몬 총 사용량, 자궁내막의 두께, 자궁내막의 형태, hCG 투여일의 14 mm 이상 난포의 수, hCG 투여일, 임신율, 다태 임신율을 비교하였으며 통계 분석은 Mann-Whitney U test or Fisher's exact test 등을 이용하였다. 결 과: 연령, 불임기간, 이전 인공수정 횟수, 기저 혈중 LH, FSH, $E_2$ 농도, 불임의 원인 등의 임상적 특성은 양 군간 차이가 없었다. 성선자극호르몬 병합 과배란유도시 배란전 자궁내막의 두께는 이전의 클로미펜을 사용한 주기와 비교하여 유의하게 증가되었다. 성선자극호르몬 총 사용량, hCG 투여일, 자궁내막의 삼중선 비율, 임신율 및 다태 임신율은 유의한 차이가 없었다. 클로미펜+성선자극호르몬 군에 비하여 레트로졸+성선자극호르몬 군에서 14 mm 이상 난포의 개수는 유의하게 적었고 ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03). 배란 전 자궁내막 두께는 유의하게 두꺼웠다 ($7.7{\pm}1.5\;mm$ vs. $9.1{\pm}1.7\;mm$, p<0.05). 결 론: 배란유도를 위하여 클로미펜 사용시 얇은 자궁내막을 보였던 환자들에서 인공수정을 위한 과배란유도시클로미펜 또는 레트로졸을 성선자극호르몬과 병합하여 사용하는 방법은 클로미펜의 자궁내막에 대한 부정적인 효과를 피할 수 있는 것으로 사료된다. 적절한 자궁내막의 발달 및 적절한 난포의 성장 측면에서 성선자극호르몬에 레트로졸을 병합하는 과배란유도 방법이 클로미펜을 병합하는 방법에 비하여 더 유용할 수 있으나 추가적인 대규모 전향적 연구가 필요할 것으로 사료된다. Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.

99mTc-HMPAO SPECT 를 이용한 알쯔하이머병의 진단에서 허혈성 뇌병변이 미치는 영향

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),이경한(Kyung Han Lee),김종호(Jong Ho Kim),권준수(June Soo Kwon),우종인(Jong In Woo) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3

N/A Brain perfsion SPECT shows typical regional perfusion abnormalities in Alzheimer's disease(AD) and is useful for its diagnosis. However, there is also arguement that these patterns show significant overlap with other causes, and the accuracy for SPECT in differentiating AD has shown conflicting results. We postulate that the variation in reported results are partly due to a difference in patient or control selection with specia reference to the mixture of ischemic cerebral disease in the atudied poulation. To determine the effect of ischemic lesions and the nature of control subjects on SPECT studies for AD, we performed 99mTc-HMPAO single photon emission computed tomography(SPECT) in 11 probable AD patients with a low (<4) Hachinski ischemic score and 12non-demented age matched controls. Magnetic resonance imaging(MRI) disclosed ischemic cerebral lesions in 27%(3/11) of the PAD group and 25%(3/12) of the control group. Regional perfusion indices were quantitated from the SPECT images as follows and the distribution of perfusion indices from both groups were compared. This was repeated with controls after excluding those with significant ischemic lesions by MRI: regional perfusion index=average regional count/average cerebellar coung All PAD patients showed perfusion abnormality in SPECT. However, 83% (10/12)of controls also showed perfusion abnormalities, and no pattern could reliably differentiate the two groups. After excluding controls with significant cerebral ischemia, the difference in temporal and perietal perfusion index was increased. A decreased temporo-parietal and any parietal or temporal perfusion index had a sensitivity of 18% and 36% in detecting AD, respectively. When using a separate group of normal age mathced controls, the indices showed an even more difference in the temporal and parietal lobes and the sensitivity of a decreased temporoparietal and any parietal or temporal perfusion index had a sensitivity of 36% and 55% in detecting AD, respectively. Thus, the type of control with special reference to the presence of ischemic cerebral lesions contribute significantly to the accuracy of perfusion SPECT in diagnosing AD. This may have particular importance in the diagnosis of AD in populations where the prevalance of cerebrovascular disease in high.

소아 이뇨 신장스캔에서 검사 표준화에 의한 폐쇄 진단 성능 향상

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최용(Yong Choi),이경한(Kyung Han Lee),현인영(In Young Hyun),최황(Hwang Choi),김광명(Kwang Myung Kim) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.4

N/A We evaluated diagnostic accuracy of diuretic renal scan with standardization in 45 childrens(107 hydronephrotic kidneys) with 91 diuretic assessments. Sensitivity was 100% specificity was 78%, and accuracy was 84% in 49 hydronephrotic kidneys with standardization. Diuretic renal scan without standardization, sensitivity was 100%, specificity was 38%, and accuracy was 57% in 58 hydronephrotic kidneys. The false-positive results were observed in 25 cases without standardization, and in 8 cases with standardization. In duuretic renal scans without standardization, the causes of false-positive results were 10 early injection of lasix before mixing of radioactivity in loplsty, 6 extrarenal pelvis, and 3 immature kidneys of false-positive results were 2 markedly dilated systems postpyeloplsty, 2 etrarenal pevis, 1 immature kidney of neonate , and 2 severe renal dysfunction, 1 vesicoureteral, reflux. In diuretic renal scan without standardization the false-positive results by inadequate study were common, but false-positive results by inadequate study were not found after standardization. The false-positive results by dilated pelvo-calyceal systems postpyeloplsty, extrarenal pelvis, and immature kidneys of, neonates were not dissolved after standardization. In conclusion, diagnostic accuracy of diuretic renal scan with standardization was useful in children with renal outflow tract obstruction by improving specificity significantly.